Care closer to home for older Western Australians

By Learne Durrington, WA Primary Health Alliance CEO

With the national spotlight firmly fixed on the Royal Commission into Aged Care Quality and Safety, many Australians will have started to consider how they would like to be cared for later in life.

In talking to friends, colleagues and my own family, I convey my wishes to choose the care I receive and where I will reside for as long as possible.  For many Australians this equates to staying in our own homes, receiving the right type of care at the right time whilst being surrounded by those we trust and love.

The conundrum is that these are hard conversations for families to have with their elderly relatives. Equally, many GPs find it difficult to talk to their ageing of terminally ill patients about what to expect and prepare for, so they can best plan their end of life care.

Some of the ways in which we can move this important conversation forward require us to challenge traditional thinking around death, dying and loss and better equip communities and health professionals to have these difficult conversations.

WA Primary Health Alliance (WAPHA), which operates WA’s three Primary Health Networks (PHNs), is working in several areas to support community and GPs.

In partnership with the City of Albany, we are coordinating the Great Southern Compassionate Communities Project, a whole of community approach to increasing awareness of end of life, and empowering people to live and die well, at home where possible. Residents living in WA’s Great Southern region are being encouraged to talk about dying, death and loss as part of this project focused on shifting community culture and improving end of life care and support.

This is part of a $9 million Australian Government across a number of PHNs to improve palliative care coordination to support people who have a known life-limiting condition by improving choice and quality of care and support.

Social isolation and loneliness is an increasing problem for older Australians, which can impact their physical and mental health. The Australian Government has invested $20 million Australia-wide to trial innovative ways to tackle this problem

Again, as part of a wider Australian Government initiative, WAPHA is working with local service providers and partners in the City of Mandurah to increase social connections for people at risk of isolation and loneliness.

We know there is increasing pressure on our primary healthcare providers to meet the demands of our ageing population. GPs are having to manage the complexities often associated with ageing including patients’ deteriorating physical health and high prevalence of mental health issues.

WAPHA is helping to build capacity among general practice teams have informed conversations about advance care planning.  This will allow GPs and practice staff to be more proactive and confident in involving patients and their families in decisions about their treatment to ensure they receive the right care when and where they need it.

As part of the Advance Project, we are working with Hammond Care to provide palliative care training for GPs, practice nurses and practice managers. This uses a practical, evidence-based toolkit and a training package, specifically designed to support general practices to implement a team-based approach to initiating advance care planning and palliative care into everyday clinical practice.

More broadly, we have been tasked by the Australian Government to increase access to primary healthcare for older Western Australians, including those living in residential aged care facilities. This includes better access to GPs, pharmacists and other allied health professionals.

For people entering residential aged care facilities, they are likely experience multiple chronic illnesses requiring a team of GPs, nurses, pharmacists, specialists and support workers to meet their healthcare needs. This transition is often coupled with feelings of trepidation, uncertainty and a loss of independence for the person and their family.

As a result, we have recently commissioned low intensity, evidence-based psychological therapies and support services for residents with a diagnosed mental illness and those at risk of mental illness, as part of the Australian Government’s $82.5 million across Australia to better support people living with a mental illness in residential aged care.

WAPHA is committed to working across the health system to improve access to primary care including palliative care, as our population ages. The challenges ahead of us are great and numerous, and we recognise these cannot be resolved by any single organisation.

We need the help of the whole system – health, social and community sectors – to work together to achieve better health outcomes for older people.